View Full Version : Chronic fatigue: Strictly biological?

10-05-05, 12:25 AM
Chronic fatigue: Strictly biological?<!--/head-->


<STORYTEXT><!--byline-->By Judy Foreman / Health And Fitness News Service<!--/byline--> (http://javascript<b></b>:scriptsearch('By%20Judy%20Foreman','phrase','','' ,'3'))

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For years, many doctors and others dismissed people with Chronic Fatigue Syndrome (CFS) as depressed, lazy, or just plain whiny.

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10-05-05, 07:45 AM
Good to hear. I may print this off the give them to my doc. I don't think it will change her mind but you never know. She (and others) just blow off my excessive fatigue.:(

10-05-05, 10:31 AM
Tuesday, October 4, 2005

Chronic fatigue: Strictly biological?

By Judy Foreman / Health And Fitness News Service

For years, many doctors and others dismissed people with Chronic Fatigue Syndrome (CFS) as depressed, lazy, or just plain whiny.

Now, a slew of research -- more than 2,000 scientific papers by some counts -- is suggesting that chronic fatigue is not a psychiatric illness, but a nasty mix of immunological, neurological and hormonal abnormalities.

Several types of brain scans, for instance, have found different patterns of blood flow to certain regions of the brain in patients with chronic fatigue, and other studies have shown that patients have difficulty in thinking and processing information, and are unable to do several mental tasks at once.

"There are objective brain abnormalities in many patients with CFS that are consistent with the symptoms patients describe," says Dr. Anthony Komaroff, a chronic fatigue expert and editor-in-chief of Harvard's Health Publications, a division of Harvard Medical School, in Boston.

Chronic fatigue, which has no known cure, is more than feeling tired all the time. Definitions vary, but the one the federal government uses says it is characterized by persistent, unexplained fatigue lasting at least six months.

In addition, four of the following are associated with CFS: sore throat, tender lymph nodes, muscle pain, multijoint pain, headaches, poor sleep, malaise after exercise and impaired memory or concentration.

The syndrome -- which can come on after an acute infection, head injury, major life stress or from no obvious triggers at all -- affects 800,000 to 2.5 million Americans, most of them women, says Dr. William Reeves, chief of CFS research at the federal Centers for Disease Control and Prevention in Atlanta.

But the ailment is tricky to diagnose because its symptoms overlap with those of other conditions, such as depression, Gulf War Syndrome and fibromyalgia.

A federal study now underway is designed to measure the activity of thousands of genes in 190 people, some with chronic fatigue syndrome, some without, to find a distinctive genetic fingerprint for chronic fatigue.

The goal, says Reeves, is a blood test for chronic fatigue.

"This illness is a nightmare that is extraordinary," says Dr. David Bell, a specialist in Lyndonville, N.Y.

"If you're lucky, you get over CFS in a couple of years. If you're not, it stays with you for the rest of your life."

Many people with chronic fatigue are first told they have depression. But the afflictions are quite different, with depression triggering an increase in the stress hormone cortisol and chronic fatigue a decline, says Harvard's Komaroff. While depression gets better with drugs like Prozac, the fatigue of CFS does not.

Exercise usually boosts energy. But being exhausted by working out is also typical of many chronic fatigue patients, perhaps because in them, exercise triggers the release of fatigue-inducing immune chemicals called cytokines. People with the syndrome sometimes can exercise as hard as healthy people -- they just feel awful for a day or two afterward, Reeves says.

"There is considerable evidence from published studies that in CFS the immune system is overactive," Komaroff says.

Given the complexity of Chronic Fatigue Syndrome, perhaps it's not surprising that treatments are piecemeal and not very effective and that some doctors get almost as discouraged as their patients.

"Very few doctors are willing to care for CFS patients because it is such a downer," says Dr. Hugh Calkins, director of electrophysiology at Johns Hopkins Medical Institutions, in Baltimore.

Still, experts point to remedies that may help relieve some of the symptoms. In doses five to 10 times lower than those used for depression, tricyclic antidepressants such as Elavil can improve sleep, Komaroff says.

And cognitive behavior therapy, which teaches people to re-evaluate their negative thoughts and behaviors, does help some people with CFS to use optimally the little energy they have.

But mostly, it's a game of patience -- and hope, that the strides in research will translate into better diagnosis and ultimately, better treatments for chronic fatigue.

Judy Foreman is an affiliated scholar at the Women's Studies Research Center at Brandeis University in Waltham, Mass.

12-16-05, 08:11 PM
Depression IS biological. No matter what the cause, the brain winds up in the same place.

PS. Those with extreme fatigue and/or excessive Daytime sleepiness should ask their doctors for (a) serum ferritin tests [more informative than testing just hemoglobin], and (b) have an overnight Sleep Study. People with sleep disorders usually do not know they have sleep disorders -- but they know that they are tired/sleepy much of the time!